A Pox By Any Other Name

Public-health officials should worry less about renaming the monkeypox virus and more about controlling its spread.

Photo Credit: Getty

Anyone wondering why medical authorities seem so ineffectual need look no further than their newfound obsession with renaming the monkeypox virus and the disease it causes. Their preoccupation with avoiding giving offense distracts from the necessary task of combating disease spread.

The monkeypox virus, discovered in 1958, got its name because monkeys were the first animals found carrying it. In fact, monkeys aren’t the natural host of the virus; the true reservoir host remains unknown.

The first human monkeypox case was identified in 1970 in the Democratic Republic of the Congo. Until recently, nearly all cases were reported in Africa. Outbreaks outside of Africa are rare, which is why the outbreak that began in May is noteworthy.

There have been nearly 50,000 cases and 15 deaths worldwide to date, with nearly all the cases outside of Africa, in countries that have not historically reported monkeypox. Previous outbreaks have resulted from transmission from animals to humans, but the current outbreak involves human-to-human transmission, almost exclusively among gay men. The U.S. has the most cases of any country (18,417) by far, but thankfully no deaths.

The current outbreak’s lack of connection to Africa prompted an international group of 29 virologists on June 10 to complain that “continued reference to, and nomenclature of this virus being African is not only inaccurate but is also discriminatory and stigmatizing.” The scientists were particularly concerned that the media was using photos of African patients to depict pox lesions. They proposed renaming the two known variants (formally known as clades) of the monkeypox virus—the Congo Basin clade and the West African clade—with names that do not reflect the geographic location where they were first detected.

Four days later, the World Health Organization announced that, in light of concerns about stigma and racism, the names of the virus, its clades, and the disease it causes should be changed. Since then, the WHO has renamed the Congo Basin variant as Clade I and the West Africa variant as Clade II and has announced it is accepting proposals to rename the disease in line with “current best practices” to avoid causing offense to any group.

Not to be outdone, the commissioner of health in New York City—the epicenter of the U.S. outbreak—wrote a letter to the WHO urging it to follow through on renaming monkeypox, “given the stigma it may engender, and the painful and racist history within which terminology like this is rooted for communities of color.”

Commentators have correctly noted the history of racist stereotypes comparing black people to monkeys, but they have not pointed to any current examples connecting monkeypox with this ugly trope. And using photographs of black people early in the pandemic to illustrate typical lesions simply reflected the reality that, until this latest outbreak, nearly all cases were in Africa, and so those were the images most readily available.

Nor is there anything about the name monkeypox that implicates Africans in the disease or the current outbreak. That the two most common variants were named for places in Africa was something of which few people outside of infectious disease specialists were aware.

Moreover, there is an important practical issue with keeping the name: it has been used in the scientific literature for a half century. Is the middle of an outbreak, in which physicians and scientists need access to that literature, the time to confuse matters with a name change?

Read the full article at City Journal.